BACKGROUND: Cognitive deficits are core features of schizophrenia that have been associated reliably with functional outcomes and now are a focus of treatment research. New rating scales are needed to complement current psychometric testing procedures, both to enable wider clinical use, and to serve as endpoints in clinical trials. METHODS: Subjects were 35 schizophrenia patient-and-caregiver pairs recruited from the UCLA and West Los Angeles VA Outpatient Psychiatry Departments. Participants were assessed with the Clinical Global Impression of Cognition in Schizophrenia (CGI-CogS), an interview-based rating scale of cognitive functioning, on 3 occasions (baseline, 1 month, and 3 months). A computerized neurocognitive battery (Cogtest), an assessment of functioning, and symptom measures were administered at two occasions (baseline and one month). RESULTS: The CGI-CogS ratings generally showed a high level of internal consistency (Cronbach's alpha=.69 to .96), adequate levels of inter-rater reliability (ICC's=.71 to .80), and high test-retest stability (ICC's=.92 to .95). Correlations of caregiver and rater global (but not "patient only rating") CGI-CogS ratings with neurocognitive performance were in the moderate range (r's=-.27 to -.48), while most of the correlations with functional outcome were moderate to high (r's=-.41 to -.72). In fact, the CGI-CogS ratings were significantly more correlated with Social Functioning than were objective neurocognitive test scores (p=.02) and showed a trend in the same direction for predicting Instrumental Functioning (p=.06). We found moderate correlations between CGI-CogS global ratings and PANSS positive (r's=.36 to .49) and SANS negative symptoms (r=.41 to .61), but not with BPRS depression (r's=.11 to .13). CONCLUSIONS: An interview-based measure of cognition demonstrated high internal consistency, good inter-rater reliability, and high test-retest reliability. Caregiver ratings appear to add important clinical information over patient-only ratings. The CGI-CogS showed moderate validity with respect to neurocognitive performance and functional outcome, and correlations of CGI-CogS with functional outcomes were stronger than correlations of objective neurocognitive performance with functional outcomes. The CGI-CogS appears to offer a reliable and valid method for clinical rating of cognitive deficits and their impact on everyday functioning in schizophrenia.
BACKGROUND:Cognitive deficits are core features of schizophrenia that have been associated reliably with functional outcomes and now are a focus of treatment research. New rating scales are needed to complement current psychometric testing procedures, both to enable wider clinical use, and to serve as endpoints in clinical trials. METHODS: Subjects were 35 schizophreniapatient-and-caregiver pairs recruited from the UCLA and West Los Angeles VA Outpatient Psychiatry Departments. Participants were assessed with the Clinical Global Impression of Cognition in Schizophrenia (CGI-CogS), an interview-based rating scale of cognitive functioning, on 3 occasions (baseline, 1 month, and 3 months). A computerized neurocognitive battery (Cogtest), an assessment of functioning, and symptom measures were administered at two occasions (baseline and one month). RESULTS: The CGI-CogS ratings generally showed a high level of internal consistency (Cronbach's alpha=.69 to .96), adequate levels of inter-rater reliability (ICC's=.71 to .80), and high test-retest stability (ICC's=.92 to .95). Correlations of caregiver and rater global (but not "patient only rating") CGI-CogS ratings with neurocognitive performance were in the moderate range (r's=-.27 to -.48), while most of the correlations with functional outcome were moderate to high (r's=-.41 to -.72). In fact, the CGI-CogS ratings were significantly more correlated with Social Functioning than were objective neurocognitive test scores (p=.02) and showed a trend in the same direction for predicting Instrumental Functioning (p=.06). We found moderate correlations between CGI-CogS global ratings and PANSS positive (r's=.36 to .49) and SANS negative symptoms (r=.41 to .61), but not with BPRS depression (r's=.11 to .13). CONCLUSIONS: An interview-based measure of cognition demonstrated high internal consistency, good inter-rater reliability, and high test-retest reliability. Caregiver ratings appear to add important clinical information over patient-only ratings. The CGI-CogS showed moderate validity with respect to neurocognitive performance and functional outcome, and correlations of CGI-CogS with functional outcomes were stronger than correlations of objective neurocognitive performance with functional outcomes. The CGI-CogS appears to offer a reliable and valid method for clinical rating of cognitive deficits and their impact on everyday functioning in schizophrenia.
Authors: Ana M Sánchez-Torres; María Rosa Elosúa; Ruth Lorente-Omeñaca; Lucía Moreno-Izco; Victor Peralta; Joseph Ventura; Manuel J Cuesta Journal: Eur Arch Psychiatry Clin Neurosci Date: 2016-06-06 Impact factor: 5.270
Authors: Joseph Ventura; Steven P Reise; Richard S E Keefe; Lyle E Baade; James M Gold; Michael F Green; Robert S Kern; Raquelle Mesholam-Gately; Keith H Nuechterlein; Larry J Seidman; Robert M Bilder Journal: Schizophr Res Date: 2010-06-12 Impact factor: 4.939
Authors: Lindsay S Schenkel; Amy E West; Rachel Jacobs; John A Sweeney; Mani N Pavuluri Journal: J Child Psychol Psychiatry Date: 2012-02-17 Impact factor: 8.982
Authors: Steven P Reise; Joseph Ventura; Richard S E Keefe; Lyle E Baade; James M Gold; Michael F Green; Robert S Kern; Raquelle Mesholam-Gately; Keith H Nuechterlein; Larry J Seidman; Robert Bilder Journal: Psychol Assess Date: 2011-03
Authors: Kristin M Healey; Dennis R Combs; Clare M Gibson; Richard S E Keefe; David L Roberts; David L Penn Journal: Cogn Neuropsychiatry Date: 2015-02-13 Impact factor: 1.871
Authors: David C Houghton; Matthew R Capriotti; Lawrence D Scahill; Sabine Wilhelm; Alan L Peterson; John T Walkup; John Piacentini; Douglas W Woods Journal: Behav Ther Date: 2017-08-10